Fracture of the pancreas in two patients after a go‐kart accident

BackgroundAfter blunt abdominal trauma, an isolated injury to the pancreatic duct is uncommon. Physical signs and laboratory parameters are often inaccurate, and missing this diagnosis can cause serious clinical problems.Case outlinesTwo young women (aged 18 and 20 years) are reported who sustained isolated trauma to the pancreatic duct in go‐kart accidents. Each patient sustained a fracture of the pancreas. This injury was diagnosed only after a period of clinical observation with repeated laboratory parameters, ultrasound and CT scan. Pancreatic tissue was conserved by performing a pancreaticojejunostomy.DiscussionAfter any episode of blunt abdominal trauma, isolated injury to the pancreatic duct should be considered. Serum analysis, ultrasonography and CT scanning can be helpful in early diagnosis. Preservation of pancreatic tissue can be achieved with a good clinical outcome

Cranial ultrasound findings in preterm germinal matrix haemorrhage, sequelae and outcome

Germinal matrix-intraventricular haemorrhage (GMH-IVH), periventricular haemorrhagic infarction (PHI) and its complication, post-haemorrhagic ventricular dilatation (PHVD), are still common neonatal morbidities in preterm infants that are highly associated with adverse neurodevelopmental outcome. Typical cranial ultrasound (CUS) findings of GMH-IVH, PHI and PHVD, their anatomical substrates and underlying mechanisms are discussed in this paper. Furthermore, we propose a detailed descriptive classification of GMH-IVH and PHI that may improve quality of CUS reporting and prediction of outcome in infants suffering from GMH-IVH/PHI

What Factors Affect Outcome in the Treatment of Fracture-Related Infection?

This international, multi-center study investigated the effect of individual components of surgery on the clinical outcomes of patients treated for fracture-related infection (FRI). All patients with surgically treated FRIs, confirmed by the FRI consensus definition, were included. Data were collected on demographics, time from injury to FRI surgery, soft tissue reconstruction, stabilization and systemic and local anti-microbial therapy. Patients were followed up for a minimum of one year. In total, 433 patients were treated with a mean age of 49.7 years (17-84). The mean follow-up time was 26 months (range 12-72). The eradication of infection was successful in 86.4% of all cases and 86.0% of unhealed infected fractures were healed at the final review. In total, 3.3% required amputation. The outcome was not dependent on age, BMI, the presence of metalwork or time from injury (recurrence rate 16.5% in FRI treated at 1-10 weeks after injury; 13.1% at 11-52 weeks; 12.1% at >52 weeks: p = 0.52). The debridement and retention of a stable implant (DAIR) had a failure rate of 21.4%; implant exchange to a new internal fixation had a failure rate of 12.5%; and conversion to external fixation had a failure rate of 10.3% (adjusted hazard ratio (aHR) DAIR vs. Ext Fix 2.377; 95% C.I. 0.96-5.731). Tibial FRI treated with a free flap was successful in 92.1% of cases and in 80.4% of cases without a free flap (HR 0.38; 95% C.I. 0.14-1.0), while the use of NPWT was associated with higher recurrence rates (HR 3.473; 95% C.I. 1.852-6.512). The implantation of local antibiotics reduced the recurrence from 18.7% to 10.0% (HR 0.48; 95% C.I. 0.29-0.81). The successful treatment of FRI was multi-factorial. These data suggested that treatment decisions should not be based on time from injury alone, as other factors also affected the outcome. Further work to determine the best indications for DAIR, free flap reconstruction and local antibiotics is warranted

Precision cutting of glassy polymers: influence of aging on the cutting process

ABSTRACT This paper presents the results of an experimental study on the influence of aging on the cutting mechanics of glassy polymers. Polystyrene (PS), a glassy polymer, typically behaves brittle when subjected to a stress, it can be made ductile by rejuvenation. It was expected that PS would show a different cutting behaviour when it would be aged or rejuvenated. To investigate this two different molecular weight PS grades were used. Both aged and (mechanically) rejuvenated samples were made from each grade and cut. Cutting forces, chip morphology and surface quality were investigated. Although the chips showed no differences in brittleness and ductility, the measured cutting forces indicated that there is a difference between aged and rejuvenated PS. Also an interesting difference in cutting forces between the two PS grades was found. Investigation of the surface quality of the PS samples showed that the aged samples have smoother surfaces than the rejuvenated samples. It can be concluded that aging does have effect on the cutting mechanics and the obtained surface roughness